Effects Of Nerve Block Combined General Anesthesia On Stress Response In Elder Patients With Lower Limb Surgery

Objective To investigate the effects of combined lumbar plexus sciatic never blockcombined general anesthesia on stress response in elder patients with lower limb surgery.Methods50old patients subject to unilateral lower limb operation were randomlyassigned to2groups: combined lumbar plexus sciatic never block and general anesthesia(group C, n=25), general anesthesia (group G, n=25). HR, SBP and DBP were recorded atdifferent time in the surgery. Blood samples were taken before anesthesia (T0), at thebeginning of the surgery (T1),30min after the beginning of surgery (T2), at the end of thesurgery (T3),1h after the end of surgery (T4) for determination of IL-6, Cortisol (COR),epinephrine (E) and norepinephrine (NE) were recorded at different time.Results There was no significant difference in characteristics between two groups.Anesthesia was maintained with propofol and remifentanil was significantly reduced in groupC compared with group G,(P <0.05). SBP was significantly increased at T1, T2and T4ingroup G compared with T0(P＜0.05). MAP was significantly increased at T1and T4in groupG compared with T0(P＜0.05). HR was significantly increased at T2and T3in group Gcompared with T0(P＜0.05). SBP was significantly higher at T1in group G than in group C(P＜0.05). HR was significantly higher at T1and T2in group G than in group C (P＜0.05).IL-6was significantly increased at T4in group C and at T2~T4in group G compared with T0(P＜0.05). COR was significantly increased at T2~T4in group C and at T1~T4in group Gcompared with T0(P＜0.05). E and NE were significantly increased at T1~T4in group Gcompared with T0(P＜0.05). IL-6, COR, E and NE were significantly increased at T1~T4ingroup G than in group C.Conclusion Combined lumbar plexus sciatic nerve block combined general anesthesiacan be more effectively inhibit stress response than general anesthesia in elderly patients.